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South Dakota rates for HCPCS 15200

Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less

Facilitymedian $955 · 10th–90th $646–$4,3650%10%20%10th90th$955Professionalmedian $1,000 · 10th–90th $631–$1,8620%10%10th90th$1,000$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $776.25 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,949.84 / $2,454.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,096.48 / $2,137.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,659.59 / $6,165.95
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,548.82 / $1,905.46
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,698.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,348.96 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,318.26 / $2,089.30
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,479.11 / $1,819.70